Available Training

How to perform Cervical Gaze testing

23 April 2025

10 mins

Reading

Two additional gaze positions are now available in VisualEyes™ 525 as an option to include in your test battery. These are called the Center Body Left and Center Body Right tests. This allows clinicians to evaluate eye movements in different body positions.

Clinicians have always been able to look at eye movements in supine positions; however, we now allow for software-guided positioning for seated positions. These tests allow for the clinician to determine if the neck is contributing to abnormal eye movements or not.

This test was not added to the default VE525 protocol, as not all patient populations may benefit from this specialized oculomotor assessment.

Protocol setup

In order to add Cervical Gaze to your protocol, go to “System Default Settings” > “Protocol Management”. Click “Gaze” > “Edit Test” and choose “Center Body Left” and “Center Body Right” to add to your desired protocol. After this has been added to the protocol, you should see the Cervical Gaze sub-tests in the Gaze menu.

Gaze is listed among many other VNG sub-tests. Currently, the user has chosen the following gaze positions: Center, Left 30 degrees, Right 30 degrees, Up 20 degrees, and Down 20 degrees. — **Figure 1:** Protocol Management.

In addition to the previously mentioned gaze positions, the user has selected Center Body Left 45 degrees and Center Body Right 45 degrees. — **Figure 2:** Adding cervical tests to Protocol Management.

You can also add these tests from the Temporary Settings page in a test session.

How to perform the Cervical Gaze tests

These tests utilize the VORTEQ™ sensor for positioning head and body prior to the test. Before performing the test, make sure your head sensor is on and connected.

**Figure 3**: Gaze screen showing sensor is not connected. Start button is disabled.

Once the patient is facing the stimulus, center the IMU so the head model is facing forward (like the patient) and the angle by the head model reads 0 degrees.

**Figure 4:** Head sensor is connected, and head model is centered.

For the test, the software will instruct you to turn the patient’s head and body 45 degrees to the left. When the patient is in the correct position, the orange target bar will turn green.

**Figure 5**: Position one of the Cervical Gaze test. Turn head and body to 45 degrees.

After two seconds of correct positioning, the target position will move to the 0-degree position indicating the patient’s head only should turn back to center.

**Figure 6**: Position two of the Cervical Gaze test. Turn head to 0 degrees.

After two seconds in the 0-degree position, the test will automatically begin. The patient will be in a neck torsion position for this test while staring at the stimulus on the screen (or performing vision denied). It is recommended the test be performed vision denied.

**Figure 7**: Test screen for Cervical Gaze test.

Cervical Gaze results and exporting

The Cervical Gaze tests will show up in your summary screen. If you perform all the tests in gaze (center, right, left, up, down, body left, and body right), the results will be split between two pages.

Graphs with eye position in degrees as a function of time for the various gaze positions. — **Figure 8:** Gaze test summary screen (page 1 of 2).

Tips for Research Module

Research Module users have the ability to export excel data following the completion of a test session. Go to Session Review > Click Export Data. This will create a folder on your desktop (or in a folder of your choosing). This will export all tests and parameters into separate excel documents.

**Figure 9:** Session Review with Export Data button for Research Module users.

Presenter

Dr Liz Fuemmeler

Dr. Liz Fuemmeler is a Clinical Product Manager with Interacoustics and Vestibular Program Director at Professional Hearing Center in Kansas City, MO. She graduated with her doctorate in 2019 from Purdue University and received specialty training in vestibular and balance disorders at Boys Town National Research Hospital and the Mayo Clinic. While at Mayo Clinic, she trained in a concussion evaluation and rehabilitation program, which focused on utilizing vestibular testing to identify the presence and extent of issues following a concussion. Utilizing this training, she established a concussion program at a private practice in Kansas City, MO and participated in interdisciplinary evaluations for the Concussion Management Center at the University of Kansas Medical Center. She is actively involved in vestibular and concussion research and regularly lectures for local, national, and international conferences. Outside of her role with Interacoustics, she co-hosts a monthly podcast called "A Dose of Dizzy'' that reviews current vestibular protocols and research. She also is the past-president of the Missouri Academy of Audiology and volunteers with the American Academy of Audiology.